A retrospective study on 69 cases of maxillary tooth transposition

Factors affecting local alveolar bone thickness in unilateral maxillary canine-lateral incisor transposition

INTRODUCTION

This study aimed to use 3-dimensional data to investigate the factors affecting local alveolar bone thickness in unilateral maxillary canine-lateral incisor transposition.

METHODS

Pretreatment cone-beam computed tomography data of 34 patients with unilateral maxillary canine-lateral transposition were imported into Dolphin Imaging software (version 11.8; Dolphin Imaging and Management Solutions, Chatsworth, Calif) for 3-dimensional reconstruction. The age, gender, and type of transposition at the beginning of treatment were recorded. The thickness and height of the transposed canine, the labiopalatal and distomedial distance from the transposed canine to the apex of the lateral incisor, the inclination of the transposed lateral incisor, the apical height of the lateral incisor, and the alveolar bone thickness in the apical plane were measured. Multiple linear regression analyses were applied to investigate the factors affecting alveolar bone thickness in the apical plane of the transposed lateral incisor. Two sample t test were applied to assess the difference of alveolar bone thickness in patients of different ages.

RESULTS

The 10 boys and 24 girls had a mean age of 12.26 ± 2.34 years. In all 34 participants, the apical alveolar bone thickness of transposed lateral incisors was significantly higher than that of the unaffected side (P <0.05). Based on multiple regression analyses, factors associated with a wider alveolar bone thickness were as follows: age (β = -0.237; P = 0.008), the labiopalatal distance from the transposed canine to the apex of the lateral incisor (β = 0.675; P <0.001), and the inclination of the transposed lateral incisor (β = 0.048; P = 0.032). Patients aged <11 years had significantly thicker alveolar bone than that of patients aged >11 years (P <0.05).

CONCLUSIONS

Patients with younger age, greater lateral incisor inclination, and greater labiopalatal distance between canine and lateral incisor had more alveolar bone thickness. Early treatment permits tooth movement within the thicker alveolar bone.

Orthodontic Treatment of Bilateral Transposition of Maxillary Canines and Lateral Incisors

Dental transposition is a severe disturbance of tooth position and its eruptive sequence. It may affect any tooth, and it may occur at any location within the dental arch, although some teeth may be more frequently affected than others. There are several types of dental transposition, and their classification depends on the type of teeth involved. The aetiology of transposition is not very clear and has always been the subject of controversies, and it is still not completely understood. The prevalence of dental transposition and the factors related to this dental anomaly have been well documented in the literature. When treating dental transposition, many factors which may affect the treatment results must be considered, such as aesthetics, occlusion, treatment duration, patient comfort, patient cooperation, and periodontal support. Various treatment options are currently available for the treatment of dental transposition. Successful treatment outcomes depend on the patient's age, concern about facial and dental aesthetics, motivation of the patient, functional requirements, type of malocclusion, and the position of the root apices. The present case report is aimed at outlining the orthodontic treatment of a young adult patient diagnosed with bilateral maxillary canine-lateral incisor transposition.

A systematic review of relative indications and contra-indications for prescribing panoramic radiographs in dental paediatric patients

PURPOSE

To systematically review the evidence of the diagnostic efficacy of panoramic radiographs (PRs) in the following six clinical situations: caries, acute dental infections, dental trauma, dental anomalies, Developmental disorders and pathological conditions in children. The research question posed by the EAPD was: "In which clinical situations and age groups is it indicated/contra-indicated to prescribe PRs in relation to these six clinical situations, in children".

METHODS

An electronic search of the following databases was conducted: MEDLINE via OVID, EMBASE via OVID, The Cochrane Oral Health Group's Trials Register, the Cochrane Central Register of Controlled Trials (CENTRAL), The Cochrane Database of Systematic Reviews (CDSR), the Database of Abstracts of Reviews of Effects (DARE) and the Cochrane Health Technology Assessment (HTA), to identify relevant studies published from 1990 to 2018. The systematic review was performed according to the PRISMA guidelines. Study screening, data extraction and risk of bias assessment of included studies was carried out independently and in duplicate using the QUADAS 2 tool.

RESULTS

The search resulted in 3420 potentially relevant studies, and following screening 175 full texts were obtained, of which 16 were finally included in the review. Meta-analysis was not possible for any of the aforementioned clinical situations, therefore the included studies were tabulated in terms of qualitative descriptive hierarchy of evidence for diagnostic.

CONCLUSION

Based on currently available evidence there is a need for high quality diagnostic accuracy efficacy studies to address important diagnostic tasks in these six clinical situations in children, as there is a lack of scientific evidence concerning PRs in children, as there would support the production of guidelines for prescribing PRs in children along with their relative indications and contra-indications.

Chang C, W. Eugene R. Vertical incision subperiosteal tunnel access and three-dimensional OBS lever arm to recover a labially-impacted canine: Differential biomechanics to control root resorption

A 15-year-old female presented with a chief complaint of unesthetic smile and protrusive lips. Lower facial height and convexity were within normal limits, but the lower lip was protrusive (3mm to the E-Line). Bimaxillary retrusion (SNA 79.5˚, SNB 76˚, and ANB 3.5˚) and a high mandibular angle (SN-MP 38˚) were noted. Lower incisors were prominent (L1 to MP 96˚ and L1 to NB 8 mm). Molars were Class I, but the upper right canine (UR3) was Class II. The upper left deciduous canine (ULc) was retained, and the UL3 was labially impacted. An oblique direction of canine eruption wedged the impaction between the keratinized mucosa and the adjacent incisor, eliciting root resorption on the labial surface of the UL2. The discrepancy index (DI) was 16. Following extraction of all four first premolars and the ULc, all teeth except the UL2 were bonded with a Damon Q® passive self-ligating bracket system. Vertical incision subperiosteal tunnel access (VISTA) technique was performed to produce a submucosal space for retraction and extrusion of the impacted UR3. A button was bonded on the UL3, and a power chain was attached. The elastomer chain exited the mucosa through a more distal incision, and traction was applied with a custom lever arm, anchored by an OBS® inserted into the left infrazygomatic crest. The impaction was retracted into a normal position between the UL2 and UL4. Once the UL3 was extruded to the occlusal plane, the UL2 was bonded and its axial inclination was corrected with a labial root torquing auxiliary. Both arches were detailed and finished. After 24 months of active treatment, the UL3 was well aligned, but the labial gingiva supporting it was immature and only partially keratinized. Follow-up visit 1.5 years later showed its maturation into a stable but relatively thin band of gingiva. In retrospect, this UL3 gingival problem may have been avoided by adjusting the three-dimensional (3D) lever arm for a more palatal emersion of the impaction. There was no change in the preexisting labial root resorption of the UL2, but no additional root resorption on any teeth occurred during active treatment. Final alignment and dental esthetics were excellent as evidenced by an American Board of Orthodontics Cast-Radiograph Evaluation score of 12, and the IBOI Pink and White Esthetic Score of 2. VISTA with an OBS 3D lever arm is an important advance for orthodontic impaction recovery. Submucosal retraction of a labially- impacted, partially transposed maxillary canine permits optimal emergence into the arch. Differential biomechanics of soft and hard tissue explains impaction-related root loss before treatment, as well as the mechanism for protecting an unrestrained lateral incisor while the impacted canine is recovered.

Prevalence of dental anomalies in French orthodontic patients: A retrospective study

OBJECTIVES

To investigate the prevalence and gender distributions of dental anomalies in French orthodontic patients.

MATERIAL AND METHODS

A retrospective review of the dental files of orthodontic patients was conducted to investigate the frequencies of dental anomalies. Pretreatment intraoral photographs and panoramic radiographs were analyzed. The occurrence rates of various dental anomalies (as determined by the numbers, shapes, structures, exfoliations, and eruptions of teeth) were calculated as percentages and differences in gender distribution using Chi² and Fisher tests.

RESULTS

Five hundred fifty-one patients receiving orthodontic treatment between 2003 and 2013 at a French hospital were included in the study: 45.74% of the patients (n=252) presented at least one dental anomaly. Taurodontism was the most common (15.06%), followed by ectopic eruption (11.43%). Odontoma, macrodontia, fusion, gemination, talon cusp, dentinogenesis imperfecta, regional odontodysplasia, premature tooth eruption, and premature exfoliation were not found. No statistically significant correlations were found between gender and the occurrence of dental anomalies.

CONCLUSION

French orthodontic patients exhibit a high rate of dental anomalies, indicating that dental anomalies should be carefully considered in the orodental management of French patients.

[The dental collection Hyacinthe Brabant: A pedagogic and scientific tool]

Among the numerous specimens preciously preserved in the Anatomical and Embryological Museum of ULB, there lies also a dental collection assembled by Professor Hyacinthe Brabant. This collection, previously unlabelled, shows several dental anomalies and pathologies as well as tumours. The objective of our study was to conduct an inventory of this collection and to set up an electronic iconographic tool through the Iconography website of ULB. A descriptive study was carried out and it was based on the analysis of 125 models and 90 extracted human teeth. The inspection of the models showed some non-odontological tumours as well as multiple dental anomalies. The extracted teeth showed generalised, coronal or radicular anomalies. The conducted inventory allowed us to classify and label the specimens and therefore to showcase this dental collection which is unique owing to its rich content and didactic display. Finally, the iconographic site will be a useful tool to raise awareness about several dental pathologies and anomalies among students and young practionners.

Dental anomalies in first-degree relatives of transposed canine probands

The aim of this study was to investigate and compare the inheritance pattern and prevalence of inheritable dental anomalies in a sample of patients with maxillary canine—first premolar transposition and their first-degree relatives with a sample of palatally displaced canine families. Thirty-five consecutive maxillary canine—first premolar transposition probands and 111 first-degree relatives were matched to 35 consecutive palatally displaced canine probands and 115 first-degree relatives. These were assessed for palatally displaced canines and incisor-premolar hypodontia. Parental age at birth of the proband was also noted. The results revealed that (i) there is no difference in the overall prevalence of palatally displaced canine or incisor-premolar hypodontia between the groups of relatives; (ii) first-degree relatives of bilateral palatally displaced canine probands have a higher prevalence of palatally displaced canine and incisor-premolar hypodontia than those with unilateral palatally displaced canine; and (iii) maternal age at birth of the maxillary canine—first premolar transposition probands was significantly higher than that of the palatally displaced canine probands. The results suggest that maxillary canine—first premolar transposition and palatally displaced canine are unlikely to be different genetic entities and also indicate environmental or epigenetic influences on dental development.

Comparison of the dental anomalies found in maxillary canine-first premolar transposition cases with those in palatally displaced canine cases

AIM

To compare the developmental dental anomalies associated with maxillary canine-first premolar (MxCP1) transposition and those of palatally displaced canine (PDC) with each other and with the background prevalence in the Maltese population in order to elucidate whether the two conditions have similar or differing genetic backgrounds.

MATERIALS AND METHODS

Dental records of 477 subjects with PDC, 57 subjects with MxCP1, and a control group of 500 subjects with no history of a PDC or tooth transposition were compared for canine eruption anomalies and hypodontia.

RESULTS

A high frequency of bilateral occurrence was present for both canine malpositions and when unilateral, a trend to right-sided occurrence was evident. The occurrence of transpositions in the PDC group and of PDC in the MxCP1 group was higher than expected. The prevalence of incisor hypodontia was significantly higher in subjects with PDC and MxCP1, as compared to the control group.

LIMITATIONS

The size of the MxCP1 group is relatively small. The study population is a small isolated Caucasian population and the results may not be applicable to other populations.

CONCLUSIONS

There is no significant difference between the MxCP1 and PDC groups in the prevalence or distribution of hypodontia and each of these groups exhibits a higher prevalence of the other canine anomaly. These findings support the theory that PDC and MxCP1 form part of a group of interrelated dental anomalies that share a common genetic basis.

The prevalence, pattern and clinical presentation of developmental dental hard-tissue anomalies in children with primary and mix dentition from Ile-Ife, Nigeria

BACKGROUND

The study of dental anomalies is important because it generates information that is important for both the anthropological and clinical management of patients. The objective of this study is to determine the prevalence and pattern of presentation of dental hard-tissue developmental anomalies in the mix dentition of children residing in Ile-Ife, a suburban region of Nigeria.

METHODS

Information on age, sex and socioeconomic status was collected from 1,036 children aged four months to 12 years through a household survey. Clinical examination was conducted to assess the presence of dental anomalies. Associations between age, sex, socioeconomic status, prevalence, and pattern of presentation of the developmental hard-tissue dental anomalies were determined.

RESULT

Two hundred and seventy six (26.6%) children had dental anomalies. Of these, 23.8% had one anomaly, 2.5% had two anomalies, and 0.3% had more than two anomalies. Of the children with anomalies, 49.3%were male, 50.7%were female, and 47.8%, 28.6% and 23.6% were children from low, middle and high socioeconomic classes, respectively. More anomalies were seen in permanent than primary dentition. Anomalies of tooth structure were most prevalent (16.1%); anomalies which affect tooth number were least prevalent (1.3%). Dens evaginatus, peg-shaped lateral, macrodontia, and talon cusp were more prevalent in the permanent dentition, and dens evaginatus peg-shaped lateral and macrodontia were more prevalent in the maxilla. There were significantly more macrodontia anomalies in males and in children of high socioeconomic status.

CONCLUSION

This large survey of dental hard-tissue anomalies found in the primary dentition and mixed dentition of children in Nigeria provides anthropological and clinical data that may aid the detection and management of dental problems of children in Nigeria.